What is Nuclear Medicine?

This is a branch of medicine that uses radiation to provide information about a person’s anatomy and the functioning of specific organs. In most cases, the information enables physicians to provide a quick, accurate diagnosis of conditions such as cancer, heart disease, thyroid disorders and bone fractures. In some cases, radiation is used to treat the condition.

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What are the benefits of nuclear medicine?

Nuclear medicine enables doctors to produce a quick, accurate diagnosis of a wide range of conditions and diseases in a person of any age. This allows the appropriate treatment to begin as early as possible, which means it has a far greater chance of being fully effective. In addition, the tests are painless and most scans expose patients to only minimal amounts of radiation. Nuclear medicine provides an effective means of examining whether some tissues are functioning properly.

Therapy using nuclear medicine is an effective, safe and relatively inexpensive way of controlling, and in some cases eliminating, conditions such as overactive thyroid, thyroid cancer and arthritis.

Nuclear medicine is a vital part of health care as it gives many people the opportunity of continuing to live full and healthy lives.

What is radiation?

Radiation is a type of energy that exists in our environment in many forms. It comes from both natural and man-made sources. Light that allows us to see, and the warmth we get from the sun or from a fire, are natural forms of radiation. Examples of man-made radiation include the microwave radiation that is used for cooking, and radio waves used for communication over long distances. Ionising radiation comes from both natural and man-made sources. It comes from outer space, the sun, the earth, the air and our food and drink, and from building materials such as concrete, bricks and mortar. This is the natural background radiation to which everyone is exposed. Nuclear medicine studies use ionising radiation, as do x-ray studies.

Is nuclear medicine safe?

Nuclear medicine is extremely safe because the radioactive tracers, or radiopharmaceuticals, used are quickly eliminated from the body through its natural functions. In addition, the tracers used rapidly lose their radioactivity. In most cases, the dose of radiation necessary for a scan is very small. For example, a patient having a lung scan is exposed to the same dose of radiation they would receive from two return air flights between Sydney and London.

How are radiopharmaceuticals produced?

Australia is one of a limited number of countries that produce the radioactive tracers necessary for diagnostic nuclear medicine. If we were not able to produce radiopharmaceuticals here, we would have to import them from as far away as Europe, South Africa or North America.

The radiopharmaceuticals are primarily manufactured at two facilities operated by ANSTO--at its nuclear research reactor located at Lucas Heights, near Sydney, and at its cyclotron at Camperdown in Sydney. Another, smaller, cyclotron operates in Melbourne. The manufacturing processes at all facilities are regulated by strict quality control requirements approved by government. Although both reactors and cyclotrons can produce radiopharmaceuticals, each produces a different type of radiopharmaceutical. Both types are supplied to nuclear medicine centres across Australia. Hence, both reactors and cyclotrons are necessary.

Every year thousands of people are diagnosed and treated at nuclear medicine centres. Without access to this vital technology, they would face a reduced quality of medical care.

When is a scan needed?

Scans using radiopharmaceuticals can diagnose all sort of conditions. Scans of the heart, thyroid, lungs and kidney are common. However, by far the majority of scans involve the skeleton. These are usually carried out to diagnose infection, tumour spread, fractures and sports injuries.

Should I prepare for a scan in any way?

Some tests may require special preparation. As with many other tests, if you are pregnant, or think you may be, or if you are breastfeeding, you must tell us. It is important that you read all the material given to you prior to your appointment. If further information is required, please ring your imaging centre.

What can I expect when I have a scan?

When you undergo a scan, a radiopharmaceutical will be given, either by injection into a vein, by mouth or through a breathing device. The radiopharmaceutical will concentrate in the particular part of your body under investigation.

Sometimes you may have to wait for a few hours or even a day or two after the pharmaceutical has been administered for the scan to be done. This is because it may take a while for the pharmaceutical to lodge in the part of your body to be examined. As the radiopharmaceutical travels, it continuously gives off invisible radiation, known as gamma rays.

Using a special camera called a gamma camera, doctors can detect the location of the radiopharmaceutical in your body. During your scan, the camera will be positioned close to the part of your body being scanned. If you are claustrophobic, please notify the staff before the radiopharmaceutical is administered.

Computers enhance the camera images on a screen. Doctors will be able to tell if the part of your body being tested is functioning normally. A copy of the images will be available for your doctor.

Will it hurt?

A scan involves nothing more painful than an injection into a vein, rather like the one you’d have for a blood test.

Will I have to stay in hospital?

Patients having a diagnostic scan will often be asked to stay only a few hours in the nuclear medicine department, although in some cases patients are asked to return for a number of visits or to stay in hospital for a short period.

If you are undergoing therapy, particularly for an overactive thyroid gland, you will probably be treated as an outpatient and won’t need to stay in hospital. If you do stay, then you will usually only be in hospital for two or three days. This is not because of any risk to your health but because doctors want to ensure that the remnants of the radiopharmaceuticals are dealt with safely when they are excreted from your body.

What does nuclear medicine treatment involve?

By far the widest application of nuclear medicine is for diagnosis. However, there are a number of occasions when radioactive materials are used to treat certain conditions, particularly cancer. This is known as therapy.

The most common conditions treated are overactive thyroid and thyroid cancer. Radiopharmaceuticals are also injected into the body, usually into the joints, to treat conditions such as arthritis. Newer treatments involve the intravenous injection of radiopharmaceuticals for the relief of pain from tumours that have spread to bone.

Who carries out nuclear medicine procedures?

If your doctor recommends you for a scan or nuclear medicine treatment, you will be placed in the care of a team of specially trained professionals. Physicians, technologists, nurses and pharmacists will ensure that you receive a high level of care and that your doctor is provided with accurate reports on your condition.

Are there any side effects?

Side effects are extremely rare for diagnostic scans. When radiation or radiopharmaceuticals are used in therapy, there are sometimes minor side effects such as nausea or swelling in the salivary glands. To prevent the latter, patients are often advised to simply suck lollies.

What happens after a scan or therapy?

The specially trained physicians will report on the scan’s appearance and send the results to your doctor to evaluate, together with those of any other tests you may have had. In the majority of cases, you will be able to continue your daily lifestyle as usual.